When the Foot Hits the Ground- Recognizing and Preventing Stress Fractures in the Foot

HEALTH WATCH : Suzanne Becker

   Just like a car, the human body has a spring-loaded shock absorbing mechanism built into the foot to disperse force. The human foot has 33 joints that allow 26 bones to move freely during impacts such as walking, running and other activities. When your foot hits the ground, the impact can be spread across all 33 joints. This lessens the overall stress in any one specific area. 

   If this shock absorption system is altered, due to muscle weakness, faulty foot mechanics, or poor technique, the long foot bones (metatarsals), are at great risk for developing a stress fracture.  

 Most Common Stress Fractures  

The most common stress fracture in the foot is in the 2nd metatarsal bone. This bone bears increased weight when the foot’s inside arch collapses. This faulty foot pattern is called over-pronation and is extremely common. In contrast, when the foot rolls to the outside, called over-supination, increased stress is placed on the 4th and 5th metatarsal bones this puts them at risk for a stress fracture.

   If you have pain in your mid-foot region with weight bearing, suspect a stress fracture in your foot. Then immediately schedule an appointment with your orthopedic doctor. Imaging tests may help your doctor confirm your diagnosis. Stress fractures are difficult to see on X-rays until they have actually started to heal. Your doctor may recommend a bone scan or a magnetic resonance imaging (MRI) scan. MRIs are more sensitive than an X-ray and can detect stress fractures early. 

   It typically takes six to eight weeks for a stress fracture to heal. During that time, switch to exercise that places less stress on your foot, such as swimming and cycling. During or after the healing process, consult with your physical therapist to have your mechanics evaluated. You may be over-pronating or over-supinating. This can cause increased force through the metatarsal bones. 

   A simple fix may be buying over-the-counter orthotics or begin specific core, hip, knee, and ankle strengthening exercises, which provide dynamic arch stability. Remember, the greatest weapon of defense against stress fractures is prevention. Run smart, eat healthy, listen to your body. And don’t hesitate to ask the advice of professionals.

Suzanne Becker is a physical therapist for Children’s Hospital Oakland, which also treats athletes at its sports medicine facility in Walnut Creek.